Abstract
Bilateral shoulder dislocations are usually of the posterior type, which is commonly associated with seizures, electrocution or electroconvulsive therapy. Bilateral anterior shoulder dislocations are very rare and usually result from significant trauma. Simple bilateral anterior shoulder dislocations without associated fracture are much rarer and not many cases have been reported in the literature. We present a traumatic bilateral simple anterior shoulder dislocation in a 24-year-old male without any features of ligamentous laxity, and review the international literature on simple bilateral anterior shoulder dislocations. From the review we conclude that seizures are as important an aetiology of simple bilateral anterior shoulder dislocation as is trauma. Moreover, this injury is not as rare as was considered in the past.
Highlights
Bilateral posterior dislocations are usually associated with seizures, electrocution and electroconvulsive therapy while bilateral anterior dislocations result from significant trauma.[2,5,6]
We present a case of traumatic simple bilateral anterior shoulder dislocation and review the international literature on this rare type of injury
The mechanism is the same as that of unilateral dislocation but the traumatic force should be uniformly distributed between the two shoulder joints to dislocate both.[2,5,11]
Summary
Shoulder dislocation is the most common type of joint dislocation encountered in humans.[1,2] Anterior shoulder dislocation represents 95% of unilateral shoulder dislocations while unilateral posterior dislocation is far less common (4%).[2,3] Bilateral shoulder dislocations do occur and unlike unilateral dislocations they are most commonly of the posterior type.[2,4] Bilateral posterior dislocations are usually associated with seizures, electrocution and electroconvulsive therapy while bilateral anterior dislocations result from significant trauma.[2,5,6] Asymmetrical bilateral dislocations with one shoulder dislocated anterior and the other one posterior are extremely rare and have been reported in the literature.[7,8]. Simple bilateral anterior shoulder dislocations without associated fracture are extremely rare. Very few cases have been reported in the literature.[4,9] We present a case of traumatic simple bilateral anterior shoulder dislocation and review the international literature on this rare type of injury. The respiratory and cardiovascular system examination was unremarkable Both upper extremities were in the attitude of external rotation and abduction. A diagnosis of traumatic simple bilateral anterior shoulder dislocation was made. Intermittent pendulum movements of the upper extremities were started at two weeks and slings were discarded at four weeks after which full range of movement of shoulder joints was started. At final follow-up of six months the patient had painless, full range of movement at the shoulder joints without any sign of shoulder instability (Figure 3)
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